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Johanna Boretzki,1,2 Eva Wolf,3 Carmen Wiese,4 Sebastian Noe,4 Annamaria Balogh,3 Anja Meurer,5 Ivanka Krznaric,6 Alexander Zink,7 Christian Lersch,1 Christoph D Spinner1,2 1Department of Medicine II, University Hospital Klinikum rechts der Isar, Munich, 2German Center for Infection Research, Partner Site Munich, 3MUC Research, Munich, 4MVZ Karlsplatz, HIV Clinical Care Center, Munich, 5Center for Infectiology and Internal Medicine, Munich, 6Center for Infectiology Prenzlauer Berg, Berlin, 7Department of Dermatology and Allergology, University Hospital Klinikum rechts der Isar, Munich, Germany Background: Reasons for and frequency of nonadherence to antiretroviral therapy (ART) may have changed due to pharmacological improvements. In addition, the importance of known non-pharmacologic reasons for nonadherence is unclear.Methods: We performed a cross-sectional, noninterventional, multicenter study to identify current reasons for nonadherence. Patients were categorized by physicians into the following adherence groups: good, unstable, or poor adherence. Co-variables of interest included age, sex, time since HIV diagnosis, ART duration, current ART regimen, HIV transmission route, comorbidity, HIV-1 RNA viral load (VL), and CD4 cell count. Patients self-reported the number of missed doses and provided their specific reasons for nonadherent behavior. Statistical analyses were performed using Fisher’s extended exact test, Kruskal–Wallis test, and logistic regression models.Results: Our study assessed 215 participants with good (n=162), unstable (n=36), and poor adherence (n=17). Compared to patients with good adherence, patients with unstable and poor adherence reported more often to have missed at least one dose during the last week (good 11% vs unstable 47% vs poor 63%, p

Abstract Background Weight stigma among healthcare professionals is associated with negative health impacts on patients, yet there are few effective strategies to combat weight stigma among health professional learners. The Body Advocacy Movement-Health (BAM-Health) is a novel group-based, peer-led stigma reduction intervention for health professional students that targets weight stigma across intrapersonal, interpersonal, and structural levels. The present study (1) assesses short-term impacts of BAM-Health participation on intrapersonal and interpersonal weight bias compared to an informational brochure control condition and (2) explores the feasibility and acceptability of BAM-Health among a sample of health professional students. Methods Sixty-seven health professional students participated in BAM-Health (n = 34) or received an informational brochure about weight stigma (n = 33). Participants completed validated self-report surveys assessing internalized weight/ appearance concerns and interpersonal weight stigma prior to their assigned intervention (baseline), immediately following intervention (post-intervention), and four weeks after intervention (follow-up). Baseline to post-intervention and baseline to follow-up effect sizes on each measure were calculated. At post-intervention, participants completed feedback surveys for thematic assessment. Results BAM-Health participation had a large baseline to post-intervention effect on internalized weight/ appearance concerns that diminished slightly at follow-up (Cohen’s d = -0.88; d = -0.62). Receipt of the informational brochure had a small effect on internalized weight/ appearance concerns (d = -0.27); however, these changes were not sustained at follow-up (d = 0.04). BAM-Health participation resulted in reductions in interpersonal obesity stigma and anti-fatness with small effect sizes (d = -0.32; d = -0.31). The effect on obesity stigma was slightly amplified at follow-up (d = -0.43); however, decreases in anti-fatness were not sustained (d = -0.13). The brochure condition failed to demonstrate effects on anti-fatness (d = 0.13, d = 0.14) or obesity stigma (d = -0.12; d = -0.12) at either time point. Between-session attrition rates of 4.5%, favorable quantitative ratings on post-session acceptability surveys, and free responses demonstrating appreciation of the virtual group environment and session activities reflect feasibility and acceptability of BAM-Health. Conclusions BAM-Health is a novel peer-led intervention that aims to reduce weight stigma among health professional students. BAM-Health met feasibility benchmarks and received positive feedback from participants, demonstrating acceptability and indicating interest among health professional students in analyzing and reducing weight stigma in their personal lives and careers. The intervention led to promising decreases in internalized and interpersonal weight stigma at post-intervention, some of which were sustained at follow-up. However, lack of effect on internalized weight/ appearance concerns measures may indicate that BAM-Health participants are more likely to reject weight stigma directed toward others following intervention, while maintaining thin ideals for themselves. Further investigation of BAM-Health with a larger sample and continued program development is warranted.

Abstract Adaptive sampling and situational awareness are key features of modern autonomous underwater vehicles (AUVs) since data quality can be improved while operation time and cost can be reduced. An example for adaptive sampling in the marine environmental context is thermocline detection and tracking. The thermocline as horizontal ocean layer separates warm and cold water and is a key feature in many marine disciplines. For example, it influences the distribution and exchange of nutrients and is a habitat for many organisms. In this paper we use an unscented Kalman Filter (UKF) based extremum seeking control (ESC) to find and follow ocean layers such as the thermocline. Computer simulations and real-world tests show that the method is able to find and track non-trivial real-world ocean layers with sensors subject to hysteresis and delay effects.

This study aimed to determine the protein requirements of the fattening phase for Nile tilapia (Oreochromis niloticus) fed fish meal-free diets. A total of 75 Nile tilapia were maintained in a water recirculation system, and five isoenergetic diets were formulated with increasing protein levels encompassing three repetitions each. The findings revealed that protein levels significantly affected (p < 0.05) certain Nile tilapia performance, yield, and composition parameters. The determined parameter values clearly indicated that Nile tilapia can be fed fish meal-free soybean meal and corn-based diets. Furthermore, the metabolic plasticity of this species concerning dietary protein concentrations was also demonstrated, with adequate performance results achieved in treatments containing from 267 to 294 g/kg digestible protein (DP), or 298 to 327 g/kg crude protein (CP), where the balance between essential and non-essential amino acids and energy resulted in adequate performance correlated to satisfactory feed conversion values and filet yields and composition. A DP concentration of 267 g/kg (298 g/kg CP) is recommended when offering corn and soybean meal-based diets during the Nile tilapia fattening phase to fish weighing between 400 and 700 g.

Abstract Purpose Neuroblastoma, the most common extracranial solid tumor in children under 5 years, often surrounds visceral arteries. This study aimed to analyze the working space provided by standardized surgical techniques at key arterial landmarks in adult cadavers. Methods We assessed in eight adult cadavers the mobilization of the left colon, spleen and pancreas, right colon, duodenum and mesenteric root, access to the bursa omentalis. The average working space score (AWSS) was evaluated at the left and right renal artery, left and right side of the coeliac trunk, superior mesenteric and common hepatic artery. The score was defined as: (0) vessel not visible, (1) working space at the vessel ≤ 1x diameter of the aorta, (2)

Abstract Here, we show that combined use of the EZH2 inhibitor GSK126 and the CDK4/6 inhibitor abemaciclib synergistically enhances antitumoral effects in preclinical GBM models. Dual blockade led to HIF1α upregulation and CalR translocation, accompanied by massive impairment of mitochondrial function. Basal oxygen consumption rate, ATP synthesis, and maximal mitochondrial respiration decreased, confirming disrupted endoplasmic reticulum-mitochondrial homeostasis. This was paralleled by mitochondrial depolarization and upregulation of the UPR sensors PERK, ATF6α, and IRE1α. Notably, dual EZH2/CDK4/6 blockade also reduced 3D-spheroid invasion, partially inhibited tumor growth in ovo, and led to impaired viability of patient-derived organoids. Mechanistically, this was due to transcriptional changes in genes involved in mitotic aberrations/spindle assembly (Rb, PLK1, RRM2, PRC1, CENPF, TPX2), histone modification (HIST1H1B, HIST1H3G), DNA damage/replication stress events (TOP2A, ATF4), immuno-oncology (DEPDC1), EMT-counterregulation (PCDH1) and a shift in the stemness profile towards a more differentiated state. We propose a dual EZH2/CDK4/6 blockade for further investigation.

Abstract Background Cardiac arrest is a common and devastating emergency of both the heart and brain. More than 380,000 patients suffer out-of-hospital cardiac arrest annually in the USA. Induced cooling of comatose patients markedly improved neurological and functional outcomes in pivotal randomized clinical trials, but the optimal duration of therapeutic hypothermia has not yet been established. Methods This study is a multi-center randomized, response-adaptive, duration (dose) finding, comparative effectiveness clinical trial with blinded outcome assessment. We investigate two populations of adult comatose survivors of cardiac arrest to ascertain the shortest duration of cooling that provides the maximum treatment effect. The design is based on a statistical model of response as defined by the primary endpoint, a weighted 90-day mRS (modified Rankin Scale, a measure of neurologic disability), across the treatment arms. Subjects will initially be equally randomized between 12, 24, and 48 h of therapeutic cooling. After the first 200 subjects have been randomized, additional treatment arms between 12 and 48 h will be opened and patients will be allocated, within each initial cardiac rhythm type (shockable or non-shockable), by response adaptive randomization. As the trial continues, shorter and longer duration arms may be opened. A maximum sample size of 1800 subjects is proposed. Secondary objectives are to characterize: the overall safety and adverse events associated with duration of cooling, the effect on neuropsychological outcomes, and the effect on patient-reported quality of life measures. Discussion In vitro and in vivo studies have shown the neuroprotective effects of therapeutic hypothermia for cardiac arrest. We hypothesize that longer durations of cooling may improve either the proportion of patients that attain a good neurological recovery or may result in better recovery among the proportion already categorized as having a good outcome. If the treatment effect of cooling is increasing across duration, for at least some set of durations, then this provides evidence of the efficacy of cooling itself versus normothermia, even in the absence of a normothermia control arm, confirming previous RCTs for OHCA survivors of shockable rhythms and provides the first prospective controlled evidence of efficacy in those without initial shockable rhythms. Trial registration ClinicalTrials.gov NCT04217551. Registered on 30 December 2019.

Abstract Predictors of rebound after correction of coronal plane deformities using temporary hemiepiphysiodesis (TH) are not well defined. The following research questions were tested: (1) Is the dynamic knee joint load useful to improve rebound prediction accuracy? (2) Does a large initial deformity play a critical role in rebound development? (3) Are BMI and a young age risk factors for rebound? Fifty children and adolescents with idiopathic knee valgus malalignment were included. A deviation of the mechanical femorotibial angle (MFA) of ≥ 3° into valgus between explantation and the one-year follow-up period was chosen to classify a rebound. A rebound was detected in 22 of the 50 patients (44%). Two predictors of rebound were identified: 1. reduced peak lateral knee joint contact force in the first half of the stance phase at the time of explantation (72.7% prediction); 2. minor initial deformity according to the MFA (70.5% prediction). The best prediction (75%) was obtained by including both parameters in the binary logistic regression method. A TH should not be advised in patients with a minor initial deformity of the leg axis. Dynamic knee joint loading using gait analysis and musculoskeletal modeling can be used to determine the optimum time to remove the plates.

Abstract Clade 2.3.4.4b highly pathogenic avian influenza (HPAI) H5N1 virus was detected in the South American sea lions found dead in Santa Catarina, Brazil, in October 2023. Whole genome sequencing and comparative phylogenetic analysis were conducted to investigate the origin, genetic diversity, and zoonotic potentials of the H5N1 viruses. The H5N1 viruses belonged to the genotype B3.2 of clade 2.3.4.4b H5N1 virus, which was identified in North America and disseminated to South America. They have acquired new amino acid substitutions related to mammalian host affinity. Our study provides insights into the genetic landscape of HPAI H5N1 viruses in Brazil, highlighting the continuous evolutionary processes contributing to their possible adaptation to mammalian hosts.

Abstract Objectives The oak processionary moth (OPM) (Thaumetopoea processionea) is a species of moth (order: Lepidoptera) native to parts of central Europe. However, in recent years, it has become an invasive species in various countries, particularly in the United Kingdom and the Netherlands. The larvae of the OPM are covered with urticating barbed hairs (setae) causing irritating and allergic reactions at the three last larval stages (L3-L5). The aim of our study was to generate a de novo transcriptomic assembly for OPM larvae by including one non-allergenic stage (L2) and two allergenic stages (L4 and L5). A transcriptomic assembly will help identify potential allergenic peptides produced by OPM larvae, providing valuable information for developing novel therapeutic strategies and allergic immunodiagnostic assays. Data Transcriptomes of three larval stages of the OPM were de novo assembled and annotated using Trinity and Trinotate, respectively. A total of 145,251 transcripts from 99,868 genes were identified. Bench-marking universal single-copy orthologues analysis indicated high completeness of the assembly. About 19,600 genes are differentially expressed between the non-allergenic and allergenic larval stages. The data provided here contribute to the characterization of OPM, which is both an invasive species and a health hazard.

Introdução/objetivos: Amostras do gênero Klebsiella, principalmente da espécie K. pneumoniae, estão os patógenos mais frequentes em infecções relacionadas à assistência em saúde e infecções invasivas adquiridas na comunidade. K. pneumoniae está entre os microrganismos mais frequentes entre amostras resistentes a múltiplas drogas. Nas últimas décadas, a resistência aos carbapenemas tem crescido, sendo associada a desfecho clínico desfavorável e aumento da morbidade e mortalidade, além do aumento dos custos de hospitalização, internações mais longas e do uso de antibióticos alternativos e mais caros. O objetivo do estudo foi caracterizar amostras de Klebsiella sp. produtoras de carbapenemases quanto aos clones que pertencem e aos genes e mutações que codificam resistência aos antimicrobianos. Materiais e métodos: 166 amostras de Klebsiella sp. produtoras de carbapenemases foram obtidas de diversos espécimes clínicos de um hospital no Rio de Janeiro entre janeiro de 2014 e janeiro de 2017 (n = 105) e março a outubro de 2020 (n = 61). Estas foram enviadas para sequenciamento do genoma completo. A identificação de espécie, MLST e genes de resistência aos antimicrobianos foram determinadas através das ferramentas on-line disponibilizadas pelo Center for Genomic Epidemiology. Resultados: Das 166 amostras do estudo 162 foram identificadas com K. pneumoniae, 3 como K. aerogenes e 1 como K. quasipneumoniae subsp. similipneumoniae. Observamos significativas mudanças clonais quando comparamos as amostras dos dois períodos (p < 0.005). Os dois STs mais frequentes em 2014-2017 (ST437 61% e ST340 11%) não foram observados no período de 2020, sendo substituídos pelo ST11 (46%), ST16 (26%) e ST258 (15%) no segundo período do estudo. Dentre os genes de resistência encontrados destacamos a presença das carbapenemases KPC-2 em 121 (73%) amostras, KPC-2 e OXA-370 em 22 (13%), OXA-370 em 11 (7%), KPC-2 e NDM-1 em 10 (6%) e NDM-1 em 2 (1%) e a ESBL CTX-M-15 em 86 (52%). Além destes, foi encontrada uma grande diversidade de genes conferindo resistência a aminoglicosídeos, trimetoprim, quinolonas, fenicóis, macrolídeos, tetraciclinas, fosfomicina, sulfonamidas e rifampicina e mutações conferindo resistência as polimixinas. Conclusões: Observamos significativa mudança clonal entre os períodos estudados e uma grande diversidade de genes que codificam resistência aos antimicrobianos, ressaltando a importância da vigilância epidemiológica de amostras produtoras de carbapenemases. Palavras-chave: Klebsiella, Klebsiella pneumoniae, Carbapenemases, KPC, OXA-48. Conflitos de interesse: Não houve conflitos de interesse. Ética e financiamentos: Aspectos éticos: Aprovado pelos Comitês de Ética em Pesquisa do HUCFF, CAAE 60433716.8.0000.5257, e da Sociedade de Ensino Superior Estácio de Sá, 39277320.5.0000. Estudo financiado por FAPERJ n.E-26/200.228/2022, INPRA/CNPq 465718/2014-0, CNPq 312205/2019-8 e CAPES 001.

Butia eriospatha (Martius ex Drude) Beccari é uma palmeira endêmica da região sul do Brasil, de valor econômico e cultural. Atualmente, a espécie está classificada como ameaçada de extinção, devido à expansão agrícola, urbanização e dificuldades de propagação da espécie. O objetivo deste trabalho foi de avaliar o efeito de fertilizantes NPK no crescimento inicial de mudas transplantadas de B. eriospatha. As mudas foram obtidas de área de regeneração natural no município de Curitibanos (SC), e transplantadas para vasos de 2,6 L contendo substrato comercial Carolina Soil®. O experimento foi conduzido em casa de vegetação, em delineamento inteiramente casualizado. Para a análise do efeito dos fertilizantes, foram utilizados sete tratamentos, sendo eles a aplicação de nitrogênio (N), fósforo (P), potássio (K), nitrogênio, fósforo e potássio (NPK), fósforo e nitrogênio (PN), nitrogênio e potássio (NK) e fósforo e potássio (PK), contendo 20 repetições cada e totalizando 140 plântulas. Os fertilizantes utilizados no experimento foram ureia, superfosfato triplo e cloreto de potássio, aplicados em períodos quinzenais. A cada bimestre foi avaliado o diâmetro de colo e altura de estipe, durante 22 meses. O melhor tratamento para o crescimento biométrico de mudas de B. eriospatha transplantadas para substrato comercial Carolina Soil® foi a associação de fósforo e nitrogênio.

IntroductionAdverse childhood experiences (ACEs) have a profound impact on children’s and adolescents’ academic performance and overall wellbeing. In contrast, positive childhood experiences help mitigate the negative effects of ACEs on health and wellbeing. Trauma-informed and social–emotional learning (SEL) programs in schools may address these impacts, with school staff playing a pivotal role in ensuring their success and influencing school outcomes. This study aimed to assess the strengths, weaknesses, and areas for improvement in the STRYV365 peak team and Brain Agents programs. The aim was to refine program implementation and determine the preliminary effects on students, teachers, and the broader school environment.MethodsTo achieve this goal, four focus groups were conducted after the program concluded, involving 17 school leaders, administrators, and teachers from four urban schools serving students in fifth through ninth grades. The audio transcripts were professionally transcribed and analyzed by four co-authors using Dedoose for inductive coding, leading to the identification of major themes and subthemes.ResultsThree key themes were identified from transcripts: school-wide perspectives of STRYV365 programs, strengths and impacts of STRVY365 programs, and suggestions for program improvement. School staff noted that the peak team was particularly engaging for students, helping them develop SEL skills and foster both peer-to-coach and peer-to-peer relationships. Additionally, the STRYV365 programs were found to enhance student–teacher relationships and staff relationships. Teachers expressed strong interest in taking a more active role in future programming.DiscussionOverall, this study highlights the importance of teacher and administrator involvement in maintaining consistent SEL activities for urban youth. The findings also suggest that short-term, 4-week SEL programs can have a positive effect on school culture, as well as on student–teacher relationships and teacher–teacher relationships.

Abstract Background We aimed to improve the image quality (IQ) of sparse-view computed tomography (CT) images using a U-Net for lung metastasis detection and determine the best tradeoff between number of views, IQ, and diagnostic confidence. Methods CT images from 41 subjects aged 62.8 ± 10.6 years (mean ± standard deviation, 23 men), 34 with lung metastasis, 7 healthy, were retrospectively selected (2016–2018) and forward projected onto 2,048-view sinograms. Six corresponding sparse-view CT data subsets at varying levels of undersampling were reconstructed from sinograms using filtered backprojection with 16, 32, 64, 128, 256, and 512 views. A dual-frame U-Net was trained and evaluated for each subsampling level on 8,658 images from 22 diseased subjects. A representative image per scan was selected from 19 subjects (12 diseased, 7 healthy) for a single-blinded multireader study. These slices, for all levels of subsampling, with and without U-Net postprocessing, were presented to three readers. IQ and diagnostic confidence were ranked using predefined scales. Subjective nodule segmentation was evaluated using sensitivity and Dice similarity coefficient (DSC); clustered Wilcoxon signed-rank test was used. Results The 64-projection sparse-view images resulted in 0.89 sensitivity and 0.81 DSC, while their counterparts, postprocessed with the U-Net, had improved metrics (0.94 sensitivity and 0.85 DSC) (p = 0.400). Fewer views led to insufficient IQ for diagnosis. For increased views, no substantial discrepancies were noted between sparse-view and postprocessed images. Conclusions Projection views can be reduced from 2,048 to 64 while maintaining IQ and the confidence of the radiologists on a satisfactory level. Relevance statement Our reader study demonstrates the benefit of U-Net postprocessing for regular CT screenings of patients with lung metastasis to increase the IQ and diagnostic confidence while reducing the dose. Key points • Sparse-projection-view streak artifacts reduce the quality and usability of sparse-view CT images. • U-Net-based postprocessing removes sparse-view artifacts while maintaining diagnostically accurate IQ. • Postprocessed sparse-view CTs drastically increase radiologists’ confidence in diagnosing lung metastasis. Graphical Abstract

Since its founding in 2013, the Young Crystallographers (YC) have become one of the most active working groups not only within their parent organization, the German Crystallographic Society (DGK), but also among other young crystallographers' groups in Europe and the world. The aim of the YC is and always has been to support early-career researchers in the diverse fields of crystallography and the rejuvenation of the field on a national scale. Over the past decade, we have curated events, platforms, and educational content tailored to foster collaboration and knowledge transfer among young crystallographers. In this article, we introduce our group and show how this active and diverse community has shaped the rejuvenation of crystallography in Germany, strengthened by the support of our national society.

To meet temperature goals that limit warming to well below 2 °C requires the removal of hundreds of billions of tonnes of CO2 from the atmosphere over the course of this century. Effective Carbon Dioxide Removal (CDR) methodologies will be required to reduce net emissions in the near term, counterbalance residual CO2 emissions to achieve net-zero in the medium term, and contribute to net-negative emissions in the longer term – all of this in a sustainable and safe manner. This paper summarizes the research objectives and selected initial results of a collaborative project to assess CO2 storage in the upper ocean crust south of Iceland.The AIMS3 project (www.aims3.cdrmare.de) will deliver new insights, monitoring tools and feasibility assessments for CO2 storage in young, reactive basalts with little sedimentary cover. Along the flank of the Mid-Atlantic Ridge, we have done geophysical surveys and drilled a transect of boreholes in order to identify fluid migration in the upper ocean crust. Both in situ heat flow and geochemical signatures provide irrefutable evidence for such transport, which will help distributing injected CO2 in future experiments.In parallel, our project also has mineralization experiments to assess optimal conditions for injection dissolved, liquid, or supercritical CO2), numerical modelling for upscaling our results from seagoing work, and development of cost-effective sensors and smart robotic landers for long-term monitoring of the vicinity of the boreholes. We outline the rationale of AIMS3, provide an overview of the activities, and highlight some of the expedition results, with the goal to stimulate communication and collaboration.

Background High blood pressure (BP) increases recurrent stroke risk. Methods and Results We assessed hypertension prevalence, treatment, control, medication adherence, and predictors of uncontrolled BP 90 days after ischemic or hemorrhagic stroke among 561 Mexican American and non‐Hispanic White (NHW) survivors of stroke from the BASIC (Brain Attack Surveillance in Corpus Christi) cohort from 2011 to 2014. Uncontrolled BP was defined as average BP ≥140/90 mm Hg at 90 days poststroke. Hypertension was uncontrolled BP or antihypertensive medication prescribed or hypertension history. Treatment was antihypertensive use. Adherence was missing zero antihypertensive doses per week. We investigated predictors of uncontrolled BP using logistic regression adjusting for patient factors. Median (interquartile range) age was 68 (59–78) years, 64% were Mexican American, and 90% of strokes were ischemic. Overall, 94.3% of survivors of stroke had hypertension (95.6% Mexican American versus 92.0% non‐Hispanic White; P=0.09). Of these, 87.9% were treated (87.3% Mexican American versus 89.1% non‐Hispanic White; P=0.54). Among the total population, 38.3% (95% CI, 34.4%–42.4%) had uncontrolled BP. Among those with uncontrolled BP prescribed an antihypertensive, 84.5% reported treatment adherence (95% CI, 78.8%–89.3%). Uncontrolled BP 90 days poststroke was less likely in patients with stroke who had a primary care physician (adjusted odds ratio [aOR], 0.45 [95% CI, 0.24–0.83]; P=0.01), greater stroke severity (aOR per‐1‐point‐higher National Institutes of Health Stroke Scale score, 0.96 [95% CI, 0.93–0.99]; P=0.02), or more depressive symptoms (aOR per‐1‐point‐higher Personal Health Questionnaire Depression Scale‐8 score, 0.95 [95% CI, 0.92–0.99] among those with a history of hypertension at baseline; P=0.009). Conclusions Greater than one third of survivors of stroke have uncontrolled BP at 90 days poststroke in this population‐based study. Interventions are needed to improve BP control after stroke.

ABSTRACT The objective of this case report was to share the successful management of severe endophthalmitis, aiming at ocular integrity and visual acuity. A 73-year-old man presented with visual acuity of 20/30 in the right eye and 20/200 in the left eye. On the 21st day postoperatively after phacoemulsification in the left eye, he developed symptoms of endophthalmitis, including ocular discomfort, blurred vision, and whitish discharge. Despite negative cultures, his condition worsened, resulting in corneal perforation on the 31st day. Conjunctival flap and penetrating keratoplasty were performed. Currently, the patient maintains a visual acuity of 20/40 in the left eye, with a healthy graft and no signs of failure. Despite the complications, careful follow-up and timely interventions successfully preserved his vision. The use of conjunctival flap during the inflammatory phase was crucial to maintaining ocular integrity. This underscores the importance of different approaches in complex ocular complications, including alternative strategies for ocular protection during active inflammation.

Este texto é um relato de experiência do grupo PET Agronomia da Universidade Federal do Recôncavo Baiano que, desde 2013, dispõe de uma área experimental onde, anualmente, cultivam-se culturas agrícolas e realizam-se pesquisas científicas para o desenvolvimento e difusão de tecnologias em agricultura. Para a execução desta atividade o grupo discute e seleciona as espécies que serão cultivadas e são elaborados projetos de pesquisa/manejo e avaliação para condução durante o período de cultivo agrícola. Além da proposta pedagógica, a experiência também objetiva desenvolver e modelar uma proposta de exploração agrícola e geração de renda para agricultores familiares do Recôncavo, a partir do cultivo de espécies frutíferas em sistema de policultivo com aplicação de princípios conservacionistas. Atualmente o sistema proposto contempla as seguintes culturas: goiaba, manga, banana, citros, caju, jabuticaba, pitaya, coqueiro, umbu-cajá, milho e aipim. A metodologia consiste na dedicação de cada discente, em média 4 horas semanais, no desenvolvimento desta atividade e discussões de campo com a presença da Tutora e/ou um professor/técnico convidado, além das oficinas técnicas e dias de campo para difusão de informações, efetivando o tripé ensino-pesquisa- extensão. Os resultados são publicados em eventos e também há previsão de organização de atividades de difusão da experiência.

Abstract New materials and technologies used in construction constantly need improvements, whereby the leveraging of new raw materials for the manufacture of products already in use, such as paving, is required. Thus, this study aimed to determine the mechanical and thermal behavior of pavers containing waste glass and São Tomé stone waste to verify their potential application as cold diffraction. Thereafter, they were comminuted and added to the mixtures for making the pavers having glass waste and São Tomé stone in the range of 0-30% by weight. Mechanical compressive strength and thermal heat absorption tests were performed. Results showed that the replacement of fine aggregates with waste glass and São Tomé stone waste in pavers reached a mechanical resistance of approximately 85% and 73% of that of the reference paver, respectively. The results show that reducing the waste content of pavers can increase the mechanical strength to reach the NBR 9781/87 values. However, pavers with lower mechanical strength can be used in paving pedestrian sidewalks, where the loads are low. Pavers with 30% glass waste achieved a 5.5% reduction in the maximum temperature, which could contribute to the reduction of urban heat islands.

Abstract Coastal systems encompass a range of ecotones that are important for fish species, providing diverse micro-habitats and grounds for foraging, protection from predation, reproduction and areas for recruitment. However, most of these systems face major threats from human activities. Considering the increasing levels of human disturbance in coastal ecosystems, understanding fish-habitat associations may provide important insights into patterns of species occurrence and distribution in human-impacted systems, which can support the development of effective conservation and management measures. In this context, we investigated the relationship between seahorses (Hippocampus reidi) and both habitat complexity and different holdfast species, to determine possible variation between locations and among seasons. Data were obtained from the rocky reefs of Guanabara (Urca Beach) and Sepetiba (Duas Irmãs Island) bays, in southeastern Brazil. Seahorses were counted, and the holdfast being used by each individual was recorded and identified to species or assigned to a morphofunctional group. The beaches differed in holdfast composition and morphofunctional groups, yet sharing some morphofunctional groups. Seahorses were more frequently associated with branching holdfasts at both sites, and also with foliaceous and massive. Association with algae were particularly found in Urca, while the coral Carijoa riisei in Duas Irmãs Island.

Summary: Background: Mucositis is a common and highly impactful side effect of conventional and emerging cancer therapy and thus the subject of intense investigation. Although common practice, mucositis assessment is heterogeneously adopted and poorly guided, impacting evidence synthesis and translation. The Multinational Association of Supportive Care in Cancer (MASCC) Mucositis Study Group (MSG) therefore aimed to establish expert recommendations for how existing mucositis assessment tools should be used, in clinical care and trials contexts, to improve the consistency of mucositis assessment. Methods: This study was conducted over two stages (January 2022–July 2023). The first phase involved a survey to MASCC-MSG members (January 2022–May 2022), capturing current practices, challenges and preferences. These then informed the second phase, in which a set of initial recommendations were prepared and refined using the Delphi method (February 2023–May 2023). Consensus was defined as agreement on a parameter by >80% of respondents. Findings: Seventy-two MASCC-MSG members completed the first phase of the study (37 females, 34 males, mainly oral care specialists). High variability was noted in the use of mucositis assessment tools, with a high reliance on clinician assessment compared to patient reported outcome measures (PROMs, 47% vs 3%, 37% used a combination). The World Health Organization (WHO) and Common Terminology Criteria for Adverse Events (CTCAE) scales were most commonly used to assess mucositis across multiple settings. Initial recommendations were reviewed by experienced MSG members and following two rounds of Delphi survey consensus was achieved in 91 of 100 recommendations. For example, in patients receiving chemotherapy, the recommended tool for clinician assessment in clinical practice is WHO for oral mucositis (89.5% consensus), and WHO or CTCAE for gastrointestinal mucositis (85.7% consensus). The recommended PROM in clinical trials is OMD/WQ for oral mucositis (93.3% consensus), and PRO-CTCAE for gastrointestinal mucositis (83.3% consensus). Interpretation: These new recommendations provide much needed guidance on mucositis assessment and may be applied in both clinical practice and research to streamline comparison and synthesis of global data sets, thus accelerating translation of new knowledge into clinical practice. Funding: No funding was received.

Abstract BackgroundHypertension, a key modifiable risk factor for cardiovascular disease, is more prevalent among Black and low-income individuals. To address this health disparity, leveraging safety-net emergency departments for scalable mobile health (mHealth) interventions, specifically using text messaging for self-measured blood pressure (SMBP) monitoring, presents a promising strategy. This study investigates patterns of engagement, associated factors, and the impact of engagement on lowering blood pressure (BP) in an underserved population. ObjectiveWe aimed to identify patterns of engagement with prompted SMBP monitoring with feedback, factors associated with engagement, and the association of engagement with lowered BP. MethodsThis is a secondary analysis of data from Reach Out, an mHealth, factorial trial among 488 hypertensive patients recruited from a safety-net emergency department in Flint, Michigan. Reach Out participants were randomized to weekly or daily text message prompts to measure their BP and text in their responses. Engagement was defined as a BP response to the prompt. The k-means clustering algorithm and visualization were used to determine the pattern of SMBP engagement by SMBP prompt frequency—weekly or daily. BP was remotely measured at 12 months. For each prompt frequency group, logistic regression models were used to assess the univariate association of demographics, access to care, and comorbidities with high engagement. We then used linear mixed-effects models to explore the association between engagement and systolic BP at 12 months, estimated using average marginal effects. ResultsFor both SMBP prompt groups, the optimal number of engagement clusters was 2, which we defined as high and low engagement. Of the 241 weekly participants, 189 (78.4%) were low (response rate: mean 20%, SD 23.4) engagers, and 52 (21.6%) were high (response rate: mean 86%, SD 14.7) engagers. Of the 247 daily participants, 221 (89.5%) were low engagers (response rate: mean 9%, SD 12.2), and 26 (10.5%) were high (response rate: mean 67%, SD 8.7) engagers. Among weekly participants, those who were older (>65 years of age), attended some college (vs no college), married or lived with someone, had Medicare (vs Medicaid), were under the care of a primary care doctor, and took antihypertensive medication in the last 6 months had higher odds of high engagement. Participants who lacked transportation to appointments had lower odds of high engagement. In both prompt frequency groups, participants who were high engagers had a greater decline in BP compared to low engagers. ConclusionsParticipants randomized to weekly SMBP monitoring prompts responded more frequently overall and were more likely to be classed as high engagers compared to participants who received daily prompts. High engagement was associated with a larger decrease in BP. New strategies to encourage engagement are needed for participants with lower access to care.